Cutting foods with extra salt, sugar key to better health

Salt and sugar — they look so harmless, so basic, so essential. Yet the rapid increase in their presence in everything from canned soups to frozen meals and yogurt snacks worries medical experts.

NANCY CHURNINDALLAS MORNING NEWS

Salt and sugar — they look so harmless, so basic, so essential. Yet the rapid increase in their presence in everything from canned soups to frozen meals and yogurt snacks worries medical experts. Dr. Arash Tirandaz, an internist on the medical staff at Texas Health Presbyterian Hospital Plano, tells his patients that cutting down on sugar and salt is one of the best ways to improve their health. "Too much sugar can cause insulin resistance, obesity and diabetes," Tirandaz says. "Salt can cause water gain and high blood pressure, which can lead to heart failure, heart attack and stroke." The studies and books that make this point keep multiplying. The World Health Organization recommended global goals for reducing salt to lower blood pressure in January. The BMJ Group, a provider of medical information and services owned by the British Medical Association, cited new studies in April supporting that effort; Britain has already undertaken a national effort to reduce salt. A recent study in Nature also explores a link between salt and autoimmune diseases such as multiple sclerosis in mice. Last year, Dr. Robert H. Lustig, a pediatric endocrinologist at the University of California, San Francisco, elaborated on his thesis that sugar is a toxic substance that causes metabolic syndrome and fatty liver disease in "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" (Hudson Street Press, $25.95). The majority of salt and sugar we consume is in processed and restaurant foods, according to the Centers for Disease Control and Prevention. Current guidelines advise adults to consume no more than 2,300 mg of sodium, or about a teaspoon of salt, per day and no more than 1,500 mg daily, or teaspoon of salt, if you are 51 or older, are black, or have high blood pressure, diabetes or chronic kidney disease. The American Heart Association recommends limiting added sugar to no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for women and no more than 150 calories per day (about 9 teaspoons or 36 grams of sugar) for men; the Harvard School of Public Health notes, however, that your body doesn't need any carbohydrates from added sugar. Many Americans exceed what they should consume of both substances, the CDC reports. Part of the reason is that many might not realize how omnipresent sugar and salt are in popular products on grocery shelves, as Michael Moss points out in his new book, "Salt Sugar Fat: How the Food Giants Hooked Us" (Random House, $28). "They're so dependent on these three ingredients," Moss says of food manufacturers. "It goes far beyond the amount we should be eating." Speaking on the phone from The New York Times, Moss, a Pulitzer Prize-winning investigative reporter, says one of the reasons that salt has become so pervasive is that it is a cheap preservative that allows the product to last longer, mask bad flavors and be sold for less money. Sugar helps sell foods because it makes the taste of food and drink "irresistible," he says. He describes a world of food scientists, many too smart to eat their own products, adjusting levels of sugar and salt to find the "bliss point" for consumers. Marketers have become increasingly clever with labels, too, he says. Half a cup of one name-brand organic minestrone has 580 mg of sodium. Similarly, shoppers may pick up a low-fat yogurt, not realizing that some servings of certain brands have more sugar than ice cream. Some of the experts he interviewed, including Paul Breslin, a geneticist, biologist and professor in the department of nutritional sciences at Rutgers, the State University of New Jersey, suggest that salt and sugar behave like narcotics, making them hard to shake. "Ultimately whatever you eat ends up in your blood, and our body wants the blood levels for everything — from carbon dioxide to oxygen to salt and potassium and lipids and glucose — to be constant," his book quotes Breslin as saying. "This is exactly what happens when you take drugs. When you inject heroin into your body, your body says, 'Holy cow, what have you done to me?' It has to try and metabolize these things, and there's all kinds of coping mechanisms for that." Dr. Carolyn Matthews, director of integrative medicine at Baylor University Medical Center, says she's seen "phenomenal results" in her patients' health when they change their eating habits. Reducing sugar and salt, she says, "may not have as dramatic effects as pharmaceuticals, but they have pleiotropic (multiple) effects, particularly with chronic diseases. There are only upsides."

Dr. Tirandaz says he's proud of patients like Roger Byrd, 63, of Dallas, who is willing to give up the tastes he loves. "Eating would give that satisfaction in the moment I ate, and then it was back to the same thing, getting heavy and unhappy," says Byrd on the phone, adding that he had been more than 300 pounds and suffering from vascular disease. In October, on Tirandaz's recommendation, he switched to a vegan diet of fruits, vegetables, legumes and whole grains, free of added salt and sugar, and dropped to 240 pounds. "I still have a ways to go. But I walk farther, I stand longer, I have more energy and sleep is good," Byrd says. He no longer browses through supermarkets, tempted to try different items. Instead, he makes a list, goes straight for what he needs and doesn't stray. His health has improved so much that Tirandaz has halved his blood pressure, blood thinner and statin medications. "My goal is to cut them in half again and get off them completely," Byrd says. "I would like to stand as an example of a person that reversed his artery disease and that others can, too."

DECIPHERING FOOD LABELS Sodium: While labels must list ingredients in order of their weight in the food, there are many types of sodium. By the time you add the sodium in salt to the sodium in baking soda, sodium bicarbonate, monosodium glutamate, sodium benzoate, sodium saccharin and sodium nitrate on the label, you may have gone way past what your body needs to function in a healthy way. Sugar: As for added sugar, the labels have too many names to list here. Some frequently used versions listed by the Harvard School of Public Health are agave nectar, brown sugar, cane crystals, cane sugar, corn sweetener, corn syrup, crystalline fructose, dextrose, evaporated cane juice, fructose, fruit juice concentrates, glucose, high-fructose corn syrup, honey, invert sugar, lactose, maltose, malt syrup, molasses, raw sugar and sucrose. SOURCE: Harvard School of Public Health, Dallas Morning News research

TIPS FOR REDUCING SODIUM Buy fresh, plain frozen or canned "with no salt added" vegetables. Use fresh poultry, fish and lean meat, rather than canned or processed types Use herbs, spices and salt-free seasoning blends in cooking and at the table. Cook rice, pasta and hot cereals without salt. Cut back on instant or flavored rice, pasta and cereal mixes, which usually have added salt. Cut back on frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings — these often have a lot of sodium. Rinse canned foods, such as tuna, to remove some sodium. Choose ready-to-eat breakfast cereals that are lower in sodium. SOURCE: National Heart, Lung and Blood Institute

TIPS FOR REDUCING SUGAR Drink water or other calorie-free drinks instead of sugary, nondiet sodas or sports drinks or blended coffee drinks. When you drink fruit juice, make sure it's 100 percent fruit juice — not juice drinks with added sugar. Better yet, eat the fruit rather than drink the juice. Skip non-nutritious, sugary and frosted cereals, and be aware that some breakfast cereals that seem healthy contain added sugar. Opt for reduced-sugar varieties of syrups, jams, jellies and preserves. Use condiments sparingly; salad dressings and ketchup have added sugar. Choose fresh fruit for dessert instead of cakes, cookies, pies, ice cream and other sweets. Buy canned fruit packed in water or juice, not syrup. SOURCE: Mayo Clinic

MAKING IT WORK Here are three changes author Michael Moss made to cut sugar in his family's diet. Empower the kids: Moss' boys can pick their own breakfast cereals if they have 5 grams or less sugar per serving. Moss says it's like an "Easter egg hunt" for the boys to find low-sugar cereals, and they usually lurk on the high shelves, where the boys need help reaching them. Make your own: Moss now makes his own tomato sauce to avoid the sugar and salt found in prepared brands. He says it takes him about five minutes to stir a can of whole or chopped tomatoes with sautied onion, garlic and spices, and he helps his boys doing homework at the kitchen table while he cooks. He makes his own pizza, too. Compromise: One of his boys says that while he's not asking for a Capri Sun (18 grams of added sugar, according to WebMD) for lunch every day, he'd like one once in a while to be more like his friends. So Moss and his wife slip one in their son's lunchbox every couple of weeks.

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